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Ketamine-assisted psychotherapy in adolescents with multiple psychiatric diagnoses.

Philip E Wolfson, Julane Andries, Daniel Ahlers, Melissa Whippo

Frontiers in psychiatry January 1, 2023 DOI: 10.3389/fpsyt.2023.1141988 via PubMed

Summary

AI-generated from the abstract

Ketamine-assisted psychotherapy (KAP) shows promise for treating adolescent mental disorders, though research is early. Four adolescents aged 14–19 with treatment-resistant depression, bipolar disorder, eating disorders, anxiety, panic, and trauma-related symptoms received sublingual ketamine followed by intramuscular ketamine. Each had symptomatic and functional improvements, and the treatment was well-tolerated. Rapid resolution of symptoms often occurs within months but is not inevitable. Family involvement appears essential to success. This modality may expand psychiatric treatment options.

Study at a glance

Characteristics Case series Case report Peer reviewed
Sample size 4
Population Adolescents aged 14–19 with comorbid psychiatric diagnoses including treatment-resistant depression, bipolar disorder, eating disorders, anxiety, panic, and trauma-related symptoms
Interventions Ketamine-assisted psychotherapy sublingual ketamine intramuscular ketamine
Topics Depression Ketamine
Keywords Adolescent psychiatry Bipolar disorder Eating disorders Ketamine-assisted psychotherapy
Citations 27
Key finding Ketamine-assisted psychotherapy was associated with symptomatic and functional improvements and was well-tolerated in four adolescents with complex, treatment-resistant mental disorders.

Abstract

Ketamine-assisted psychotherapy is a promising new treatment for a variety of mental disorders of adolescence. There is currently an adolescent mental health crisis, with a high prevalence of disorders, diagnostic complexity, and many adolescents failing to respond to conventional treatments. While there is strong evidence for the use of ketamine in adults for a variety of treatment-refractory mental illnesses, research in adolescents is in its early stages. Ketamine-assisted psychotherapy (KAP) has been described in adults with promising results and here we present the first published cases of the use of KAP in adolescents. The four cases include adolescents aged 14-19 at the initiation of treatment, each with a variety of comorbid diagnoses including treatment-resistant depression, bipolar disorder, eating disorders, anxiety, panic, and trauma-related symptoms. They each initially received sublingual ketamine, followed by sessions with intramuscular ketamine. Their courses varied, but each had symptomatic and functional improvements, and the treatment was well-tolerated. Subjective patient reports are included. Rapid resolution of symptomatology and suffering often occurs within months as the result of the application of KAP to adolescent psychiatric care but is not inevitable. Family involvement in the treatment process appears to be essential to success. The development of this modality may have a singularly positive impact that will expand the psychiatric toolbox and its healing potency.

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